Ventilators for Covid-19: A Scramble for Africa

The COVID-19 crisis is certainly not all about ventilators*, but their availability is emerging as a revealing index of preparedness for a pandemic crisis.

As the UK scrambles to get another 8,000 ventilators this week, aiming to have 18,000 in place for the projected peak of the UK’s first Covid-19 crisis, it’s worth bearing in mind that the Central African Republic has 3.[1] Nigeria, with 200 million across its territories, appears to have no more than 500.[2] South Africa about 6000.[3] The awful reality is that the number of ventilators across Sub-Saharan Africa could be less than that of the UK alone.

And yet Africa may need them more than anywhere. Our first defence against mankind’s oldest enemy is, still: wash your hands. Yet, 40% of sub-Saharan Africa is without access to clean water.[4] For millions in crowded urban dwellings or refugee camps, self-isolating when sick is not an option. And the concomitant health problems across Africa – HIV, malaria, sickle cell, tuberculosis, and so on – make Covid-19 patients more vulnerable to its complications and certainly make healthcare infrastructure more strained. What are the prospects for African nations being able to ‘flatten the curve’? Can African countries source working ventilators fast enough? And, at least as important, are there enough local staff trained in safely operating them? Can the doctor/nurse-population ratios – currently among the lowest in the world – be scaled up quickly enough to meet fast-approaching demand?

But the principle shortage in Africa at the moment is reliable and relevant information.

More to the point, African governments are having to enact damaging economic and social policies now – largely in imitation of what the western world is doing – in the absence of clear information about their own health status in relation to the pandemic.

No-one presently knows how many people in Africa have been infected with coronavirus. In its first season, millions of blood tests have been taken in countries with diagnostic infrastructure in place to identify the virus’ movement across parts of Asia, Europe and North America. Substantive data for African countries is a long way off. In its absence, trying to track and anticipate the movement of the virus and align public health responses, border closures, economic policies, business decisions (for example, when to reopen key tourism) across Africa, will be vastly challenging.

At the moment it is clear, however, that ‘medical diplomacy’ – utilising vital medical supplies, manpower and training as assets in soft power relations – will become an increasingly important aspect of international relations in the 2020s, as global public health is kept high on the agenda of all countries.

* Early, aggressive use of ventilators is beginning to be questioned in some cases as we learn more about the Covid-19 threat and figure out how to manage it. ICU doctors are sharing instances of Covid-19 patients presenting with catastrophically low oxygen levels but still able to talk and breath normally.